Audit of IV access sites in Medical Ward Patients

Abstract no. 24published_or_final_versio

The dose-response relationship between CPAP adherence and the daily performance in subjects with OSA

Poster Session - 2-E2: Respiratory Neurobiology and Sleep 1: abstract PS379This journal suppl. entitled: Special Issue: Abstracts of the 18th Congress of the Asian Pacific Society of Respirology ... 2013BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) affects our daily functional and cognitive performance. Continuous Positive Airway pressure (CPAP) treatment may improve our symptoms and quality of life to different extents. This study investigated the relationships between CPAP adherence and daytime sleepiness, quality of life, emotion, and adherence-related cognition in subjects with OSA, after 1 year of CPAP use. METHODS: Subjects who were newly diagnosed of OSA and CPAP therapy navie were recruited. Epworth sleepiness scale (ESS), Calgary sleep apnea quality of life index (SAQLI), Depression anxiety stress scale (DASS21), and Self-efficacy measure for sleep apnea questionnaire (SEMSA), were …link_to_OA_fulltex

Increased serum levels of advanced glycation end-products is associated with severity of sleep disordered breathing but not insulin sensitivity in non-diabetic men with obstructive sleep apnoea.

BACKGROUND: Patients with diabetes mellitus are known to have increased serum levels of advanced glycation end-products (AGEs), and this is also associated with insulin resistance. This study aimed to investigate the relationship between serum AGEs and insulin sensitivity in non-diabetic subjects with obstructive sleep apnoea (OSA). METHODS: Adult males with no known comorbidities were recruited from the sleep clinic of a university teaching hospital. They underwent overnight in-laboratory polysomnography. Fasting blood was taken to measure serum AGE and plasma glucose levels. Insulin sensitivity was estimated using the short insulin tolerance test. RESULTS: In total, 105 subjects with a mean age of 43.5 (standard deviation [SD] 9.2)years, mean body mass index of 27.1 (SD 4.0)kg/m(2), and median apnoea-hypopnoea index (AHI) of 17 (interquartile range 5-46) were analysed. Serum AGE levels were significantly higher in subjects with OSA (AHI >/=5), compared with those without OSA (AHI <5) (3.9 [SD 1.2] vs. 3.2 [SD 0.8]mug/ml, respectively; P=0.037) after adjusting for confounders. AGE levels were positively correlated with AHI (r=0.318, P=0.001), but not with insulin sensitivity. AGE levels decreased in subjects with moderate-to-severe OSA who received continuous positive airway pressure (CPAP) treatment for three months (n=18, P=0.017). CONCLUSIONS: Serum AGE levels correlate with AHI in non-diabetic adult males. This relationship cannot be explained by insulin sensitivity. Supporting the hypothesis of a direct relationship between AHI and AGEs, AGE levels were found to decline with CPAP therapy.link_to_subscribed_fulltex

Self efficacy predicts adherence to continuous positive airway pressure therapy in obstructive sleep apnea

B108 Diagnostic and Therapeutic Approaches in Sleep APNEA - Poster Discussion SessionINTRODUCTION: Continuous positive airway pressure (CPAP) therapy is the standard treatment for obstructive sleep apnea (OSA). However, low CPAP adherence limits its treatment effectiveness, and it has been recognized as a contributing factor to poor physiological and psychosocial health in untreated or under-treated OSA patients. This study investigated the relationships between CPAP adherence, biomedical and cognitive factors in subjects with OSA. METHODS: Subjects who were newly diagnosed of OSA and CPAP therapy naïve were recruited. Their demographic, anthropometric and physiological data were obtained after the in-laboratory sleep studies. They filled in Self Efficacy Measure for Sleep Apnea (SEMSA) questionnaire (measuring cognitive perception of risk, outcome expectancies and self-efficacy) in addition to the Epworth Sleepiness Scale (ESS). Fixed CPAP pressure was prescribed after in-laboratory titration as indicated. CPAP adherence was objectively measured at 1 and 4 weeks after CPAP use. RESULTS: 91 subjects (14 females) were evaluated, with mean ± SD age of 52 ± 9 years, body mass index (BMI) of 29 ± 5.6 kg/m2, ESS score of 9 ± 5, apnea-hypopnea index (AHI) of 28.7 (21, 53) /hr. Mean days of CPAP use (>= 4hrs/day) in 1 and 4 weeks were 3.9 ± 2.7 days and 18.9 ± 9.5 days, respectively. On univariate analysis, there were no significant associations between CPAP adherence and clinical parameters (age, gender, BMI, sleep parameters), prescribed CPAP pressure and sleepiness. Self-efficacy score of cognitive perception measured before the start of CPAP therapy was associated with CPAP use in 1 week (ß=1.272 (0.556, 1.987)) and 4 weeks (ß= 4.163 (1.462, 6.863)), but not risk perception and outcome expectancies. Multiple linear analysis showed self-efficacy score is a significant predictor of CPAP adherence at 1 and 4 weeks after adjusting for age, gender and OSA severity. CONCLUSIONS: Self efficacy score of cognitive perception is a significant predictor of adherence to CPAP therapy in OSA.link_to_OA_fulltex

Effects of brief motivational interviewing on continuous positive pressure adherence in obstructive sleep apnea: a randomized contrilled trial

Abstract no. P4